'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

RCGP launches petition to demand 'cast iron guarantee' that GP trainees' pay will not be cut

The RCGP has launched a petition calling on the health secretary to provide a ‘cast iron guarantee’ that GP trainees will not see their pay cut as a result of the new imposed junior doctors contract.

The college said it remained ‘very concerned’ that the proposals would cut trainees’ pay, despite being given reassurances by Jeremy Hunt that trainees would not be adversely affected.

Dr Maureen Baker, the chair of the college, said there is ‘growing confusion and alarm’ around the issue.

As Pulse reported last week, the GP Survival group claimed that trainees were facing a one-third pay cut due to the Government removing the GP Registrar (GPR) supplement – which increases GP trainee pay in line with junior hospital doctors – as part of its imposition of a contract on junior doctors.

However, Dr Baker soon said that the college had been given assurances by the health secretary in a letter that other incentives to join general practice would be brought in to replace the GPR supplement.

But in the latest move, the RCGP said it was launching a petition to seek clarification from the health secretary on what these other incentives will be.

The petition calls on Mr Hunt to give ‘urgent and imperative’ reassurances that the new contract will ‘not have a detrimental effect on pay and conditions of medical graduates choosing general practice, and to provide clarification about how the proposals will work, particularly in light of the proposed removal of salary supplements that GPs receive during their training’.

A statement from the RCGP said: ‘The college is concerned that despite reassurances from the secretary of state following this letter, there remains a lack of clarity and transparency about his plans to replace the supplement and that is already having a chilling effect on the number of young doctors choosing to train as GPs.’

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In a letter accompanying the petition, Dr Baker says that the ‘alarm’ surrounding the new contract threatens to ‘drive a coach and horses through our joint recruitment efforts’ to get graduates into general practice.

She adds: ‘The Government now needs to move quickly to plug the information vacuum by sending out a clear message that no GP trainee will be worse off under the new arrangements than under the GP trainee supplement.’

The college is demand clarification on:

What the new basic level of pay will be for a GP trainee.

The level of the recruitment and retention premium and whether this will be equivalent to the current GP trainee supplement.

Whether the premium will cover all GP trainees, regardless of location.

Whether the premium will remain in place for all future GP trainees.

Whether those in other specialities who choose to retrain in general practice will continue to benefit from pay protection, so that they are not penalised financially as a result of their decision.

NHS Employers has adopted the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to remove the GPR supplement. But both NHS Employers and the DDRB said that it should be replaced with a ‘flexible pay premium’.

However, there are no details about what this will encompass.

GP Survival issued a statement warning that the effect of the removal of the existing supplement would be a one-third pay cut for GP trainees.

But NHS Employers said that the rates of pay for all trainees had not yet been negotiated, and any calculations made were based on speculation.

The BMA last week told Pulse that it is still trying to determine how much GP registrars will be paid.

A spokesperson said: ‘We are seeking to clarify the position with the Government,’ adding that the BMA’s position was set out in a statement on its website.

The statement said that the Government’s proposals could potentially mean ‘less pay for GPs’. It said: ‘The Government continues to state that it is going to introduce thousands of GPs to fill the shortfall, but how can that be achieved if GP trainees are paid much less, on average, than hospital trainees? This would be the effect of removing the GP supplement.’

Respect your people but also respect your enemy. But as history always tells us(or if you are a fan of GOT) , the ferocity of any political conflict so often involved the 'rest of the family',especially the next generation ,the younger ones OK.These politicians want to revenge on us because of the GP contract in 2004 but this does not provide the excuse to hurt our following generations. Nothing had moved me more last year when all these young people went on the streets in Hong Kong to protest against a government which has no interest in their future. Yes, you can get a low pay job but you never really have the chance to move up the scale(and the politicians take credit of how low the unemployment rate is). Of course, the bottom line is a purge;to wipe us out all together. The insult on us is beyond any limits. 'you can kill a scholar but you must not humiliate him/her' There is no place to spread the evil amongst our innocents. This is war and we must solidify..........'Those with no virtue holding high positions in hierarchy , spread the evil through the most'(不仁者居高位，是播其惡於衆也）Mencius(孟子）

Real risk here though of the royal colleges fighting between themselves for what will inevitably be a 'share of the pot' which is flexible pay supplement.

Should all band together and tell the DOH to F-off and threaten to pull all trainees all together from hospital posts until proper provision is put in place for training and remuneration. For far too long it's been known that hospitals abuse junior doctors and nothing done about it.